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Ultrasound activates the brain's waste removal system in Alzheimer's patients
Among the many moving parts that scientists suspect may play a role in Alzheimer's disease is one known as the glymphatic system, which is believed to eliminate chemical waste from the brain. A new study has demonstrated how this recently discovered system could be activated through ultrasound, and the technique has proven effective in stimulating its activity in patients as part of the first human trials.
The use of ultrasound as a treatment for Alzheimer's disease is starting to gain traction thanks to promising research in rodents. Much of this research focuses on how targeted ultrasound can open the blood-brain barrier to allow the passage of drugs to break down amyloid plaque buildup, which is associated with disease progression.
In this new study, conducted at West Virginia University, scientists delved a bit deeper into the physiological effects of opening the blood-brain barrier. The experiments involved three volunteers with early-stage Alzheimer's, aged 61, 72, and 73, who received ultrasound treatment targeted at the hippocampus, the region associated with learning and memory. Dyes were used to enhance contrast, and the participants were observed with MRI scans to track the resulting changes in the brain, showing that the dye moved through what are known as drainage veins.
"This imaging pattern was unexpected and improves our understanding of brain physiology," says Rashi Mehtam, who led the research. "The glymphatic system, which is a waste removal and fluid movement system exclusive to the brain, has been studied in animals, but there is controversy over whether this system actually exists in humans. The imaging pattern we discuss in the paper provides evidence not only to support that the system likely exists in humans but that focused ultrasound can modulate fluid movement patterns and immune responses along this system."
The scientists see this as evidence that using targeted ultrasound to open the blood-brain barrier may induce an immune healing response around the drainage veins in patients with early-stage Alzheimer's. It also adds to our understanding of the glymphatic system and the different ways we can influence its activity for better health outcomes, which include low alcohol consumption, regular deep sleep, or even sleeping on one’s side.
"This observation may be an important clue in understanding the physiological mechanism by which focused ultrasound modifies brain amyloid levels and could be used to treat patients with Alzheimer's disease and other brain disorders," says Mehta.
With ongoing trials, the researchers will continue to explore this idea by enrolling more participants and examining the long-term effectiveness and safety of the technique.
